Pediatric EHRs Need Special Features Tailored to Children

Electronic health records used in the care of children require specific pediatric functionalities to support the work of providers and to assure the delivery of quality care for patients.

That is the finding of a new report from the Agency for Healthcare Research and Quality. The report, based on research conducted by the Vanderbilt University Evidence-based Practice Center under contract with AHRQ, searched scientific literature and gathered expert opinions on EHRs used for pediatrics.

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“We hope this report encourages all stakeholders to collaborate on this effort to improve electronic health records, ensuring we provide the best possible care for children,” states the report, which lays out the special features related to a child’s evolving physiology, maturity and associated conditions not found in EHRs used for adult patients. Specific pediatric EHR functionalities include: the ability to build and maintain vaccination records, record growth and development data, calculate weight and age-based medication dosing, manage pediatric diseases, identify pediatric norms such as developmental milestones, and document the relationship between pediatric patients and their parents and caregivers.

The report recommends six core functionalities to optimize EHRs for pediatric care:

*Vaccine forecasting and management (reflects regional requirements, supports documentation, including combination vaccinations, and communicates with registries).

*Routine healthcare maintenance (facilitates longitudinal assessment of growth and development, calculates body mass index, growth velocity, percentiles, and standard deviations, allows customized growth charts as approved by clinician, and provides tailored longitudinal health and safety recommendations).

*Family structure (links families together for easy navigation and data sharing between family members, and supports dynamic privacy controls that support differential access to health data).

*Documentation and billing (integrates into a clinician’s workflow to reduce documentation overload, supports use and creation of customized forms, interfaces with schools and community health organizations).

*Medications (facilitates medication prescribing by weight, body surface area, and age, and incorporates dose rounding tailored to a medication’s safety and efficacy profile).

*Management of vulnerable populations (generates patient lists based on key clinical diagnoses or risk factors, identifies patients in a clinical subpopulation who are due for preventative services, and incorporates clinical practice guidelines into a standard clinical workflow and to identify areas for improvement).

“While many of these functionalities are not purely pediatric, their key role in the care of children in contrast to their minimal role for adults could mean they can get overlooked if an EHR is designed primarily for adult care,” concludes the report. “Yet, if these functionalities are implemented well, the EHR will also undoubtedly better support the care of all patients.”

The full AHRQ report can be found here.